Beating ‘the widow maker’

As a doctor, he knew what his own EKG meant—and it wasn’t good

Michael Disciglio, M.D., understands better than most patients the critical difference an emergency angioplasty can make-like the one performed on him by Rita Watson, M.D.

It’s said that just before you die, your whole life flashes before your eyes. But for a local physician who recently suffered a major heart attack, the flashbacks that came before he underwent lifesaving treatment at Monmouth Medical Center dated back just 13 years—to the birth of his son.

Heart attacks are the leading cause of death for both men and women, and Michael Disciglio, M.D., an internist in practice for more than 25 years, almost became an addition to those grim statistics. The electrocardiogram performed minutes after he arrived in Monmouth’s Emergency Department last April showed that he was suffering a very massive acute myocardial infarction, the medical term for a heart attack. The EKG revealed a complete blockage of his left anterior descending (LAD) artery, the heart’s main artery. Blockages there are so dangerous that the artery has been nicknamed “the widow maker.”

Dr. Disciglio was well aware of his dire condition. “I told the ER doctors I was a doc- tor and wanted to see my EKG,” he recalls. “When I did, my eyes popped out—I was shocked. I thought back to my days as a resident right here at Monmouth in 1987. Back then, if we read an EKG like that, we knew the patient was not going to survive. And all I could think about was my son, that I was going to miss seeing him grow up.”

But the good news for Dr. Disciglio, 59, and his only child, 13-year-old Michael Patrick Disciglio, was that treatments for acute myocardial infarctions have come a long way since the 1980s. In 2006, Monmouth joined the American College of Cardiology in launching a national quality-improvement initiative aimed at ensuring that patients in Dr. Disciglio’s condition—he had what is called ST-segment elevation myocardial infarction (STEMI)—undergo emergency angioplasty within 90 minutes, a window of time that can mean the difference between life and death.

The ST segment of the EKG specifically measures the LAD, which is how Dr. Disciglio knew his condition. The ER physicians activated the Code STEMI, with the on-call cardiologist and the specially trained cardiac catheterization team called in for emergency treatment. The Code STEMI team that cared for Dr. Disciglio was led by interventional cardiologist Rita Watson, M.D., who acted quickly, performing a lifesaving emergency angioplasty 79 minutes after his diagnosis.

“Dr. Watson did a miraculous job,” he says. “The next day my EKG was normal, and after three days I felt ready to go back to work. Of course, she laughed at me.” Instead, he took off about six weeks to rest, recover and undergo cardiac rehab at Monmouth’s Joel Opatut Cardiopulmonary Rehabilitation Program. (See “Comeback From a Heart Attack,” right.)

Dr. Disciglio, a single father who lives in Eatontown, calls himself “the last guy anyone expected to have a heart attack.” Most victims have some risk factors, such as smoking or diabetes, or warning signs. But he is a trim, athletic nonsmoker with normal blood pressure and cholesterol. Adding to the irony is his special interest in cardiology—on the night of his heart attack, he had given a lecture on cholesterol at an area restaurant. When he returned home, he started feeling pressure in his chest. But he’d had a negative stress test just a month before, so he ignored it until the pain grew worse and traveled to his jaws and teeth. That’s when he decided he needed to get to an emergency room.

“What happens is, you can have plaque attached to your arteries, but no blockage, which is why my stress test was normal,” he explains. “But sometimes the attachment ruptures, and the plaque immediately blocks the artery. That’s what happened to Tim Russert,” he says, referring to the NBC-TV newsman who died of a sudden heart attack soon after a normal stress test last year.

“I feel extremely fortunate that I lived long enough to get to the hospital and have this procedure performed,” says Dr. Disciglio. “In the time of my residency, a patient like me would have died or been left a cardiac cripple. I was lucky enough to survive—and I get to see my son grow up.”

The Joel Opatut Cardiopulmonary Rehabilitation Program at Monmouth Medical Center is designed for people recovering from heart and lung disease, as well as those who want to improve their cardiovascular health through disease- prevention and health-promotion services. The program features state-of-the-art fitness equipment, including treadmills, rowing machines, stationary bicycles and arm ergometers (they work like bicycles for the arms, promoting an upper-body workout).

The unit’s staff works closely with doctors and patients in developing exercise programs that meet each patient’s individual needs. Workouts are conducted under the supervision of registered nurses specially trained in coronary and pulmonary care. These professionals monitor each person’s vital signs to measure the body’s response to the exercise.

Monmouth’s cardiac rehabilitation program is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) a national multidisciplinary association. Certification recognizes those programs that are rigorously reviewed by a national board and found to meet essential requirements for standards of care.

For more information about cardiopulmonary rehab at Monmouth Medical Center, call 732-923-7459.

For more information on cardiac services at Monmouth Medical Center, please call 1-888-724-7123

This article appears in the January 2010 issue of Monmouth Health & Life

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